Kim Stanley E, Lewis Daniel D, Pozzi Antonio, Seibert Rachel L, Winter Matthew D
Comparative Orthopaedics Biomechanics Laboratory and Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610, USA.
Am J Vet Res. 2011 Mar;72(3):410-6. doi: 10.2460/ajvr.72.3.410.
To determine the influence of stifle joint flexion angle, cranial cruciate ligament (CrCL) integrity, tibial plateau leveling osteotomy (TPLO), and cranial tibial subluxation on the distance between the location of the origin and insertion of the CrCL (CrCL(d)) in dogs.
4 pairs of pelvic limbs from adult dog cadavers weighing 23 to 34 kg. Procedures-Mediolateral projection radiographs of each stifle joint were obtained with the joint flexed at 90°, 105°, 120°, 135°, and 150°. Radiopaque markers were then placed at the sites of origin and insertion of the CrCL. Afterward, radiography was repeated in the same manner, before and after CrCL transection, with and without TPLO. Following CrCL transection, radiographs were obtained before and after inducing overt cranial tibial subluxation. Interobserver variation in measuring the CrCL(d) without fiduciary markers was assessed. The effect of CrCL integrity, cranial tibial subluxation, flexion angle, and TPLO on CrCL(d) was also determined.
Interobserver agreement was strong, with an intraclass correlation coefficient of 0.859. The CrCL(d) was significantly shorter (< 1 mm) at 90° of flexion; otherwise, flexion angle had no effect on CrCL(d). Cranial tibial subluxation caused a 25% to 40% increase in CrCL(d). No effect of TPLO on CrCL(d) was found, regardless of CrCL integrity, forced stifle joint subluxation, or flexion angle.
Overt cranial tibial subluxation in CrCL-deficient stifle joints can be detected on mediolateral projection radiographs by comparing CrCL(d) on neutral and stressed joint radiographs at joint angles between 105° and 150°, regardless of whether a TPLO has been performed.
确定犬 stifle 关节屈曲角度、颅交叉韧带(CrCL)完整性、胫骨平台水平截骨术(TPLO)以及颅侧胫骨半脱位对 CrCL 起止点间距离(CrCL(d))的影响。
取自体重 23 至 34 kg 的成年犬尸体的 4 对骨盆肢。程序——在关节分别屈曲 90°、105°、120°、135°和 150°时获取每个 stifle 关节的内外侧投影 X 光片。然后在 CrCL 的起止点处放置不透射线标记物。之后,在 CrCL 横断前后、进行和未进行 TPLO 的情况下,以相同方式重复进行 X 光检查。在诱导明显的颅侧胫骨半脱位前后获取 CrCL 横断后的 X 光片。评估在没有基准标记物的情况下测量 CrCL(d)时观察者间的差异。还确定了 CrCL 完整性、颅侧胫骨半脱位、屈曲角度和 TPLO 对 CrCL(d)的影响。
观察者间一致性较强,组内相关系数为 0.859。在 90°屈曲时 CrCL(d)显著缩短(<1 mm);否则,屈曲角度对 CrCL(d)无影响。颅侧胫骨半脱位导致 CrCL(d)增加 25%至 40%。无论 CrCL 完整性、强迫 stifle 关节半脱位或屈曲角度如何,均未发现 TPLO 对 CrCL(d)有影响。
通过比较 105°至 150°关节角度下中立位和应力位关节 X 光片上的 CrCL(d),无论是否进行了 TPLO,均可在 CrCL 缺失的 stifle 关节中检测到明显的颅侧胫骨半脱位。